How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $316.23 Median $4,365.16 Typical High $14,125.38 | Facility | None | $316.23 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $2,570.40 | Professional | None | $223.87 | $316.23 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $147.91 | Professional | None | $97.72 | $114.82 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $2,691.53 Median $7,585.78 Typical High $10,000.00 | Professional | None | $2,691.53 | $7,585.78 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $2,884.03 | Facility | None | $512.86 | $1,659.59 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $363.08 | Professional | None | $245.47 | $288.40 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $478.63 | Facility | None | $316.23 | $316.23 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Sentara Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $10,232.93 | Facility | None | $204.17 | $912.01 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $7,762.47 | Professional | None | $204.17 | $263.03 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $407.38 | Professional | None | $173.78 | $281.84 | $407.38 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $104.71 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $41.69 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $158.49 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $31.62 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.89 | $31.62 | $31.62 |
Where Virginia sits
The same service costs 19.5 times more in Texas than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Virginia· 48th of 51
$200
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.